08 December 2005

A hypochondriac's worst enemy

The internet can do hypochondriacs more harm than good.

For Melissa Woyechowsky, the fear she had a terrible disease started with tingling and numbness in her legs. She searched the Web for a cause of her symptoms, ended up in a neurological chat room, and came to a devastating conclusion - she must have multiple sclerosis.

"I was reading people's posts, and it sounded exactly like what I had," Woyechowsky says. "I was sure I was dying."

In fact, several doctor visits and hundreds of dollars in tests later, Woyechowsky was diagnosed with a different disorder: hypochondria, or the excessive fear of illness.

The Internet, with thousands of sites dedicated to human health, is enabling anyone with a computer easy access to an unprecedented array of medical information that was once largely the realm of physicians. While most doctors say the Web is helping patients find out the latest in treatment advances and empowering consumers with the knowledge to take better care of themselves, there is a downside. For people prone to hypochondria, the Internet can stir up fears as debilitating as any disease.

"The Internet doesn't cause people to become hypochondriacs, but since the Web has so much health information on it some of those folks will gravitate toward it," says David Ginsberg, a New York University Medical Centre psychiatrist.

"For most people medical information on the Web is a positive development. But for those who have hypochondria, it can inadvertently reinforce their fears."

That's what happened to Woyechowsky. She was at little risk for HIV, but got tested for it more than 20 times. She found little lumps under her tongue, and went to several doctors, afraid she had lymphoma. Her anxiety soared to new heights a year ago, when she and her husband were staying at a hotel while they looked for an apartment.

The 30-year-old real estate broker spent five hours a day on her laptop in multiple sclerosis chat rooms. Her heart was beating so rapidly she was afraid to drive. After several months, she didn't want to go out in public.

"I had always had a tendency toward hypochondria," says Woyechowsky, "The Internet added rocket fuel to it."

Ever-increasing anxieties

An estimated four to six percent of a doctor's patient roster are considered hypochondriacs, says Dr Brian Fallon, an associate professor of psychiatry at Columbia University.

For them, a headache is not caused by stress, but a brain tumour. Fatigue is not attributable to a poor night's sleep, but AIDS. In a desperate quest to reassure themselves, they may visit doctor after doctor. Even after tests rule out a particular disease, they feel little relief.

"The medical profession isn't perfect and it does make mistakes," Fallon says. "The fact that there is ambiguity becomes a porthole for someone with an anxiety disorder to enter and expand upon and enhance their anxiety until it becomes a huge source of fear."

Most people at some point experience a mysterious ache or an ambiguous test result and worry they may have a serious illness, Fallon says. Even medical students, bombarded with health information, are not immune to this. But a person with hypochondria becomes so obsessed with the fear they let it interfere with their day-to-day lives, even after doctors and tests have ruled out a disease.

Until recently, the worried sick had to go to libraries and dig out medical reference books to get information about the hundreds of diseases that can afflict humans. But now, that information is at their fingertips. The Internet is home to medical journals and chat rooms for comparing symptoms.

"Patients can plug in their symptoms and out comes a list of diagnoses that might match their symptoms," Fallon says. "They are coming in with files filled with the possibilities."

Needed: 'Appropriate context'

Part of the problem is that not all health information on the Internet is accurate. In other cases, the scary-sounding side effects of drugs, or banner headlines that scream of disease outbreaks, when taken in context, pose minuscule risk to most people.

"It's important that information be presented in an accurate way and with the appropriate context," Ginsberg says. "On the Internet, the information is not being filtered or discussed with them in a way that a physician would."

Ironically, the Internet, which initially fed Woyechowsky's fears, also led her to treatment. As she scoured the Web, she came across a site for anxiety. The symptoms sounded familiar. A psychiatrist prescribed her Prozac, an anti-depressant that has also been found to relieve hypochondria.

Finally, years after her ordeal began, she started feeling better.

"The Internet can help you or hurt you," says Woyechowsky, who has started a Web site and online support group for people with anxiety problems. "The Internet was a big part of my problem. It was also a big part of my cure."


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